OASIS as a Tool to Measure Patient Outcomes and Improve Quality of Home Healthcare

Outcome and Assessment Information Set
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Outcome and Assessment Information Set
Outcome and Assessment Information Set (OASIS) is a group of data items designed to assess and measure the outcomes of patients receiving home healthcare services and determine reimbursement for home health agencies. According to Thomas et al. (2020), these assessments are standardized and are completed at various points; when a client starts receiving home healthcare, when they are transferred, without discharge from the agency, to an inpatient health facility, when they resume care at the agency after release from the inpatient facility, and when the patient is discharged from the agency. The assessments are also completed at death and for service recertification. Over the years, the Centers for Medicare and Medicaid Services (CMS) has updated OASIS to enhance its reliability and validity. OASIS is a national tool, and all Medicare/Medicaid-certified home health agencies must complete and submit the assessments (Thomas et al., 2020). This facilitates their reimbursement for services provided to eligible patients. The purpose of this paper is to discuss the validity and reliability of the OASIS tool in measuring patient outcomes, in research, and in improving the quality of home healthcare.
OASIS Reliability and Validity in Measuring Patient Outcomes
Primarily, OASIS data are collected by clinicians working in-home healthcare, such as nurses and physical/ speech therapists (Ikonne & Jesus, 2021). This can be either through interviews with patients or through direct observation of patients. Even though the data sets are standardized, each clinician collecting and evaluating patients is different, raising reliability issues. According to Ikonne and Jesus (2021), clinicians are subjective because of their other evaluations, interpretations, and experiences, which is a source of concern on the inter-rater reliability of OASIS. Clinicians can make the same observations about specific OASIS indicators but interpret or evaluate them differently. This can affect the reliability of OASIS because of differing data outputs, yet the words were the same.
However, according to the CMS (2018), findings from the field tests of OASIS reveal that the tool measures patient outcomes reliably. For each patient product, specific items are calculated using the OASIS tool, which is moderately reliable. For instance, the functional objects on the OASIS tool had a moderate agreement (CMS, 2018). Specifically, the agreement level was higher at discharge than at admission/ start of care at home health agencies. The OASIS items, such as the patient’s grooming, toilet hygiene, and ability to prepare light meals, among others, were measured reliably using the OASIS tool at admission as well as discharge. In addition, clinicians become better at using the OASIS tool over time, thus increasing its reliability. CMS (2018) reveals that clinicians are more familiar with the OASIS items at patient discharge than at admission or readmission, indicating that they learn how to use the OASIS tool in collecting and evaluating patient outcomes. The OASIS tool can become more reliable if more home healthca...